Knee Replacement

Under general or spinal anaesthesia, the surgeon makes a midline anterior incision over the knee and a medial parapatellar arthrotomy to expose the joint. Cutting jigs guide precise resection of the distal femur, proximal tibia and (if indicated) the posterior patella; the femoral, tibial and patellar prosthetic components are then trial-fitted, balanced for ligament tension, and finally cemented or press-fit into place. A polyethylene insert is locked onto the tibial tray, the wound is irrigated and closed in layers.

1. 1Pre-operative assessment with bloods, ECG, MRSA screen and anaesthetic review.
2. 2Dental check to clear any focal infection; treat skin lesions on the operative limb.
3. 3Optimise weight, stop smoking, and engage in pre-habilitation quadriceps and hip exercises.
4. 4Arrange home modifications: raised toilet seat, walking frame, removal of trip hazards.
5. 5Stop NSAIDs and certain anticoagulants per surgical team instructions before surgery.

1. 1Day 0-1: Stand and walk a few steps with physiotherapy, usually within 12-24 hours.
2. 2Days 1-3: Hospital discharge with crutches; range-of-motion and quadriceps exercises begin.
3. 3Weeks 1-2: Outpatient or home physiotherapy; wound check and stitch/clip removal at 10-14 days.
4. 4Weeks 4-6: Most people walk without aids and resume desk work; driving usually permitted at 6 weeks.
5. 5Weeks 6-12: Return to low-impact sport (cycling, swimming, golf).
6. 6Months 3-12: Maximal functional recovery; routine orthopaedic follow-up.